[Three-year follow-up results of visual inspection with acetic acid/Lugol's iodine (VIA/VILI) used as an alternative screening method for cervical cancer in rural areas].

Background and Objective:In China,there is not an established national program for prevention and treatment of cervical cancer,and the screening methods and experiences are especially lack in the rural areas.This study was to evaluate the effect of visual inspection with acetic acid /Lugol's iodine (VIA /VILI) used as an alternative cervical cancer screening method in the rural areas in China by analyzing the large-scale populationbased screening data from the demonstration site.Methods:Women aged 30-59 years from Xiangyuan County in Shanxi Province were recruited for Cervical cancer screening from 2005 to 2007.VIA /VILI was the primary screening method followed by colposcopy if the VIA /VILI result was positive.cervical lesions were diagnosed by directed biopsy under the colposcopy.The women with VIA/VILI negative or cervical intraepithelial neoplasia (CIN) 1 were re-screened using the same procedure in the next year.The screening effect was evaluated by comparing the screening results.Results:Of 9558 women involved,7145 (74.75%),with mean age of 42.16 years,received the cervical cancer screening.A total of 1287 women were consecutively screened for three times during 2005-2007.The detection rates of CIN 2,CIN 3,and cervical cancer were 0.70% (9 /1287),1.01% (13 /1287),and 0.23% (3 /1287) in the first round screening,and 0.22% (2 /976),0.11% (1 /976),and 0% (0 /976) in the second round screening,respectively.Only one CIN 2 was found in the third round screening.During 2006-2007,3490 women were screened consecutively twice;the detection rates of CIN 2,CIN 3,and cervical cancer were 0.26% (9 /3490),0.52% (18 /3490),and 0.15% (5 /3490) in the first round screening,and 0.40% (14 /2943),0.40% (14 /2943),and 0.03% (1 /2943) for the second round screening,respectively.Likewise,2368 women were screened consecutively twice during 2007 2008 ;the detection rates of CIN 2,CIN 3,and cervical cancer were 0.55% (13 /2368),0.25% (6 /2368),and 0.12% (3 /2368) in the first round screening,and 0.42% (10 /2040),0.04% (1 /2040),and 0% in the second round screening.The cumulative detection rates for CIN 2,CIN 3,and cervical cancer were 0.81% (58 /7145),0.74% (53 /7145),and 0.17% (12 /7145),respectively,in which 53.45% (31 /58) of CIN 2,69.81% (37 /53) of CIN 3,and almost all (11 /12) cervical cancer were found during the first round screening;only 1 of 12 was found to be early stage cervical cancer (Ⅰa) in the second round screening.The mean ages of patients with CIN 1,CIN 2,CIN 3,and cervical cancer were 38.65,40.61,44.10,and 46.73 years,respectively.Conclusions:VIA /VILI could be used as an alternative screening method for cervical cancer and high-grade precancerous lesions among the women aged 30-59 years in rural areas due to its low cost,easy training for the local health providers,and less depending on facilities.One round screening by VIA /VILI could detect more than a half of CIN 2,two-thirds of CIN 3,and almost all the cervical cancer in the population,and the detection rate of CIN2 /3 can be increased by two consecutive rounds of screening.